| NPI | 1821430463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DE f1-0000874) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD S03743) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2016-04-05 |